Eosinophilic esophagitis (EoE) is a chronic, progressive, type 2 inflammatory disease of increasing prevalence, characterized by symptoms of dysphagia and reduced quality of life. A dysregulated type 2 immune response to food and aeroallergen leads to barrier dysfunction, chronic esophageal inflammation, remodeling, and fibrosis. Patients with EoE have impaired quality of life because of dysphagia and other symptoms. They may also suffer social and psychological implications of food-related illness and expensive out-of-pocket costs associated with treatment. Disease burden in EoE is often compounded by the presence of comorbid type 2 inflammatory diseases. Current conventional treatments include elimination diet, proton pump inhibitors, and swallowed topical corticosteroids, as well as esophageal dilation in patients who have developed strictures. These treatments demonstrate variable response rates and may not always provide long-term disease control. There is an unmet need for long-term histologic, endoscopic, and symptomatic disease control; for targeted therapies that can normalize the immune response to triggers, reduce chronic inflammation, and limit or prevent remodeling and fibrosis; and for earlier diagnosis, defined treatment outcomes, and a greater understanding of patient perspectives on treatment. In addition, healthcare professionals need a better understanding of the patient perspective on disease burden, the disconnect between symptoms and disease activity, and the progressive nature of EoE and the need for continuous monitoring and maintenance treatment. In this review, we explore the progression of disease over the patient's lifespan, highlight the patient perspective on disease, and discuss the unmet need for effective long-term treatments.

中文翻译：

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嗜酸性粒细胞性食管炎的疾病负担和未满足的需求。

嗜酸性粒细胞性食管炎 (EoE) 是一种慢性、进行性 2 型炎症性疾病，患病率不断增加，其特征是吞咽困难症状和生活质量下降。对食物和空气过敏原的 2 型免疫反应失调会导致屏障功能障碍、慢性食管炎症、重塑和纤维化。由于吞咽困难和其他症状，EoE 患者的生活质量受损。他们还可能遭受与食物有关的疾病的社会和心理影响以及与治疗相关的昂贵的自付费用。EoE 中的疾病负担通常因共病 2 型炎症性疾病的存在而变得更加复杂。目前的常规治疗包括消除饮食、质子泵抑制剂和吞服局部皮质类固醇，以及对已经出现狭窄的患者进行食管扩张。这些治疗显示出不同的反应率，并且可能并不总是提供长期的疾病控制。对长期组织学、内镜和症状性疾病控制的需求尚未得到满足；用于可以使对触发因素的免疫反应正常化、减少慢性炎症并限制或预防重塑和纤维化的靶向治疗；以及早期诊断、确定治疗结果以及更好地了解患者对治疗的看法。此外，医疗保健专业人员需要更好地了解患者对疾病负担的看法、症状与疾病活动之间的脱节、EoE 的进展性以及持续监测和维持治疗的必要性。在这篇综述中，我们探讨了患者一生中疾病的进展，